Individual provider Active NPI

Madeleine Park, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1891573143
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
36 E 57TH St FL 5
New York, NY 10022-2500
Phone
(212) 600-2000
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

36 E 57TH St FL 5
New York, NY 10022-2500

Mailing address

36 E 57TH St FL 5
New York, NY 10022-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108006185 TX Practitioner - Physician Assistant 2668823279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

341 Wheatfield Dr
Sunnyvale, TX 75182-4639

4333 N Josey LN
Suite 104
Carrollton, TX 75010-4620
Phone (972) 394-4500

8200 Walnut Hill LN
Dallas, TX 75231-4426
Phone (214) 345-8441

8230 Walnut Hill LN
Suite 220
Dallas, TX 75231-4425
Phone (214) 345-8692

874 Ed Hall Dr
Kaufman, TX 75142-1800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Dec 1, 2023 Accepting new patients
Atria Physician Practice New York, PC PastSince Oct 1, 2021 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

8230 Walnut Hill Ln
Ste 220
Dallas, TX 75231
Phone (214) 345-8692

874 Ed Hall Dr
Ste 107
Kaufman, TX 75142
Phone (469) 770-6041

874 Ed Hall Dr
Ste 116
Kaufman, TX 75142
Phone (972) 932-5506

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24265/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1891573143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 E 57TH ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 E 57TH ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222500",
            "telephone_number": "212-600-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MADELEINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.